Aortic Valve-Sparing Surgery Procedure

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The reimplantation technique in aortic-valve sparing surgery involves sewing a tube-shaped aortic graft below the level of the aortic valve.
The technique is particularly appropriate for patients with Marfan Syndrome. These patients often have a weakened or dilated aortic valve annulus. The reimplantation technique helps stabilize the annulus, preventing further dilation after surgery.
The valve-sparing reimplantation procedure takes four to five hours. You will be asleep during surgery.
First, the surgeon makes an incision in the front of the chest, opens the breastbone, and exposes the heart. Blood from the heart is redirected to a bypass machine. The bypass machine does the job of the heart and lungs during the operation.
Then, the surgeon cuts the aorta just above the aortic valve annulus and coronary ostia. The surgeon removes the diseased part of the aortic wall and surrounding tissue.
The surgeon then chooses an appropriately sized tube graft. This graft, made of polyester, will replace the part of the aorta that was just removed. The surgeon brings the bottom part of the tube graft down and around the aortic valve, just below the annulus. The graft is then secured to the valve with sutures.
Then, the surgeon reimplants the aortic valve inside the tube graft. The surgeon reconstructs the aortic root and reattaches the coronary arteries to the graft.
Finally, the surgeon sews the top part of the tube graft to the remaining section of the aorta.
After the reimplantation is complete, the surgeon shuts down the heart-lung bypass machine, and the heart starts beating again. The surgeon then closes the breastbone and both incisions, and applies bandages to the incision sites.